Another Day, Another Battle

The last few weeks have been maddening, so much so that I have been unable to write anything meaningful or at the very least something that didn’t make me seem like the candidate for anger management classes that I am.

Many of you will find this hard to believe but our most recent “issues” have been with the state funded health insurance that Max carries due to his chronic medical conditions. I know hard to believe, huh? Health insurance companies are difficult enough to deal with let alone those run by the State! It all started just before we left for Baltimore last March when I received a “congratulatory” letter telling me that my application for Max to be enrolled in the State’s clinic based healthcare had been approved. Application, what application? I have spent the last nine years fighting tooth and nail to keep my son OUT of this program, how the hell did this happen?

Seething, I got on the phone thinking it would be easy to get us out of this mess because Max has primary private insurance which means he does not have to be subjected to the hell known as the Children's Rehabilitative Services (CRS) clinic. Surely, I could get someone to see the logic in this and disenroll him. But instead I was told that, “Based on your son’s cardiac defects he must be enrolled in CRS to receive cardiac care.” To which I replied, “Really? How was he able to receive cardiac care, which you paid for I might add, for the last nine years, including no less than four cardiac surgeries? Was no one able to figure out his diagnosis then?” After much discussion the nurse case manager started to see the logic in my argument and told me not to worry whenever the State received a claim for Max’s cardiac care they would simply pay it out of the CRS budget, there was no need for him to come to clinic. I smugly hung up the phone feeling like I had saved the day…..once again!

This power trip was to be a short one. Not long after my first discussion with CRS I started to receive multiple phone calls from various nurse case managers asking me for all types of information regarding Max, his diagnoses, care, etc. At this point I’m thinking, can’t you people read your own records? Don’t you know all of this already? Why are you asking me questions whose answers must be in Max’s file? I’ve seen this file it’s HUGE. Can’t you people read (by this point I had serious doubts)? However, I never took into account that the State’s filing system leaves a lot to be desired, this became crystal clear when I received another phone call asking me why my son had received no cardiac care since December 2006. Are these people kidding? In this timeframe he has had one open-heart surgery, two cardiac CTs, four cardiac MRIs, enough echocardiograms to fill a DVD library and this woman is asking me why my cardiac kiddo hasn’t had care? Holding my breath and weighing my words (not a talent that comes easily to me) I suggested to this woman that if I had not sought cardiac care for my child in nearly four years I would hope that she would report me to Child Protective Services for neglect! I think my sarcasm was lost on this one but oh well!

Thinking the interrogations had ended I never expected the next call I got. This time they were calling to intimidate me, either I used the CRS clinic for ALL of Max’s care (remember, they originally told me that they would only be handling his cardiac care) or they would not pay and I would be solely responsible for all medical bills. Really? Have these people seen my bank account? There’s NO WAY that’s going to happen. We have worked very hard since Max’s birth to assemble the best team of doctors that we could, if they think I’m going to give this up to see the idiots they refer to as doctors they have another thing coming. In fact, I suggested that if they insist I use their cardiologist, the very same doctor that nearly killed my son before his last open-heart surgery because he dragged his feet for so long, I would be more than happy to bring a malpractice suit up against the whole lot of them. It was strange how quickly they changed their tune. As of now, I’ve set the situation straight…. again, but something tells me not to hold my breath, someone will call me next week with some other ludicrous story.

So now do you understand the lack of blog posts? Have a great weekend all!